13 December, 2011

In Connecticut, 4,700 people take up smoking cigarettes every year. If the new warnings that will be required on all cigarette packs lessen that number even a little, said Bryte Johnson of the state chapter of the American Cancer Society, it's a step in the right direction.

"If we're able to cut back [the number of new smokers] by 1, 2, or 3 percent, those are huge numbers," he said. "We don't need to change the world; we just need to change it a little bit at a time."

The U.S. Food and Drug Administration made public Tuesday the nine new warnings that it will require on all cigarette packs by September 2012. The warnings pair text messages such as "Cigarettes cause cancer" and "Smoking can kill you" with images, most depicting the consequences of smoking cigarettes.

One shows a pair of lungs ravaged by tobacco. Another depicts a man with a cigarette in his hand and smoke cigarettes billowing out of a hole in his throat.

"I think they're pretty gross, and I think they can be effective," Johnson said.

He expects that the images could cause a number of current smokers to kick the habit, and will be most effective in keeping young people from taking up smoking cigarettes at all.

"If you're smoking cigarettes because you think cheap cigarettes are cool, I think they'd have a chilling effect," he said. The warnings also will include contact information for local smoke cigarettes cessation programs, which Johnson called a "proactive" way to address the issue.

Ross Buck, a professor of communication sciences at UConn, said the images will have a greater impact than the words. Buck, who has co-authored a chapter on the psychology of warning messages for a forthcoming book, said pictures have a more immediate impact on emotions than words.

Of the nine images, the only one he has any doubts about is one of a baby facing a hovering cloud of smoke. Buck thinks it might be too "artsy."

"I think the most effective warning is the one that tells it like it is, the one that illustrates the consequences," he said.

Buck said he was glad that FDA officials took on the job of creating and selecting the images themselves rather than handing it over to the cigarettes online industry. When the cigarettes store industry was ordered to create anti-smoking cigarettes ads as part of a $206 billion settlement, Buck said, the results often sent a mixed message.

"Some of the warnings created by the discount cigarette online companies that were supposed to give young people an anti-tobacco message had the opposite effect," he said, adding that these ads implied that "only brave kids smoke cigarettes and only independent kids smoke." "The anti-tobacco people didn't see this when they approved the ads."

As jarring as the images are, Buck said, they "pale in comparison" with the warning images he has seen on cigarette packages in other countries. In Canada, he said, the images are even more graphic.

Dr. Lawrence Deyton, director of the FDA's Center for Tobacco Products, said one thing they learned during the selection process of the nine images was that the most effective images weren't always the most graphic.

"There's some literature that something that is so gross and disturbing, people will sometimes tune out and they don't pay attention," he said. "Some of [the more graphic images] didn't score as well, perhaps as a result of this. Some that were less graphic, but tugged on the heartstrings were every effective, like the one with the woman in tears, or the baby with smoke cigarettes encroaching. We tried to find a balance of images."

In any case, Buck said, they're much better than the text-only warnings currently on cigarette packs in the U.S.

"Those are designed to be ineffective," he said. "They are small, and they're not noticeable. You easily overlook them with the attractive packaging of the product itself."